| NPI | 1073773867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N2335) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME106298) |
| 207N00000X Dermatology (Licence: DC MD038210) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX N2335) | |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2020-09-23 |